Individual provider Active NPI

Theodore Bens, DPM

  • Podiatrist
  • Taylor, MI
National Provider Identifier
1669562815
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
5901001481 Issued in MI
Practice address
9224 Pelham Rd
Taylor, MI 48180-3832
Phone
(734) 284-7600
Fax
(313) 292-8430
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 5901001481 MI Primary

Addresses

Primary practice location

9224 Pelham Rd
Taylor, MI 48180-3832

Mailing address

9224 Pelham Rd
Taylor, MI 48180-3832
Phone (734) 284-7600

Other identifiers 2

IdentifierTypeStateIssuer
2649282MedicaidMI
4858255590OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050902000048 MI Practitioner - Podiatry 8820020548 Practice locations: Flat Rock, MI; Taylor, MI
I20200630001620 FL Practitioner - Podiatry 8820020548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
D.H. Medical, LLCGroup PAC ID 6103014618, 19 clinicians

Practice addresses (Care Compare)

226 N Nova Rd
Suite 184
Ormond Beach, FL 32174-5124
Phone (888) 808-0488

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue2263
Removal or shaving of skin growth992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
D.H. Medical, LLC CurrentSince Oct 1, 2020 Accepting new patients
Pardee Foot Clinic Podiatrist CurrentSince Jan 1, 1990 Accepting new patients
Mary Rose Corporation PastSince Apr 13, 2025 Accepting new patients
Robert a. Yagoobian, D.P.M., P.C. Podiatrist PastSince Nov 8, 2020 Accepting new patients

Locations

226 N Nova Rd
Ormond Beach, FL 32174
Phone (386) 235-1489

735 Dunlawton Ave
Port Orange, FL 32127
Phone (386) 872-5190

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1669562815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9224 PELHAM RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803832",
            "telephone_number": "734-284-7600",
            "fax_number": "313-292-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9224 PELHAM RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803832",
            "telephone_number": "734-284-7600",
            "fax_number": "313-292-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENS",
        "first_name": "THEODORE",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2649282",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "4858255590",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.